I read and referenced a very good article recently that stated there’s no such thing as a healthcare consumer. The article used this as the basis for a pretty convincing argument about the failure of Google Health.

While I agree with most of the article, the definition of “consumer” is too narrow: "someone who uses personal dollars to buy goods and services for his or her own use." I agree that individuals in the healthcare system are insulated from most of the spending, but, with high-deductible rate plans and increasing premiums, individuals are getting closer to the transaction itself.

This is why we are seeing the launch of services like 2nd.md and CarePilot. Their success remains to be seen, but they are targeting the consumer in the definition above.

I have taken to using the term healthcare consumer. Within the US healthcare system, there are massive differences in the amounts of services (dollars) consumed by different individuals and groups. The challenge is targeting solutions at the big — or potentially big — consumers of healthcare, those with chronic diseases and those at the end of life.

End-of-life care is a policy/legal battle without an app, device, or service, other than those that already exist, such as hospice. That leaves chronic disease as the biggest potential bang for the buck.

How do you target chronic disease? Recent information shows that people with chronic disease (and their caregivers) are motivated and even willing to pay for connected health devices and services. But it’s not easy, or else we would be seeing more success in this arena.

IBM did a good job in its recent report on connected health devices by breaking the population into:

Motivated Health – younger and proactive people who are interested in ways and tools to help them stay healthy.

Information Seeker – people with chronic needs that are not yet life threatening.

Segmenting the market this way makes a lot of sense. The needs and the associated functionality, partners, and payers are very different across the three segments.

The report then went on to outline strategies to target Information Seekers, who it describes as "underserved" by device makers. I see Information Seekers much like the examples given in the report. I’d describe them as your typical middle-aged American — gaining a few pounds every year, maybe with high blood pressure or cholesterol, pre-diabetic or non-insulin dependent diabetic, basically somebody with metabolic syndrome.

This population will very likely develop diabetes, heart disease, and/or have a stroke at some point. Any of these would acutely worsen quality of life — both for them and those around them — and significantly increase their consumption and cost of care. It would also likely move them from Information Seeker to Chronically Monitored and make any interventions more difficult.

This segment of the population is massive. Thirty-four percent of all adults over age 20 meet the criteria for metabolic syndrome. About 210 million people in the US are between 15 and 64, so using some approximation, that’s about 80 million people with metabolic syndrome that desperately need some effective intervention before it is too late. Blacks and Hispanics are more likely than non-white Hispanics to meet the criteria for metabolic syndrome.

How do you target this large and growing group? The good news, compared to over 65 and Chronically Monitored, this group is more likely to own and be able to use a mobile device, more likely to use Facebook, and more likely to be paying for at least some part of their healthcare.

The bad news (or good news, depending on your perspective) is that members of this group have not yet experienced a catastrophic health event. Talking to them about losing weight, eating less salt, or taking their meds as prescribed can be exceptionally frustrating. They nod in agreement and then come back the following year eight pounds heavier.

I’m not quite sure if it is a matter of motivation, lack of insight, or both. Either way, they are hard to target because they don’t necessarily HAVE to think about their poor health every day. They don’t (yet) carry a glucometer, walk with a cane, or experience chest pain or shortness of breath walking to the mailbox.

I’ve hopefully set up a case for why healthcare consumers do exist and matter, especially those sliding down the slippery slope of metabolic syndrome. I want to write a series of posts examining efforts to target consumers with health tools. I want to discover who has been successful in offering consumer-facing health products, demonstrating adoption and impact on chronic disease.

I’ll keep the list of companies and offerings as broad as possible for now. From there, I’d like to explore the impact of mobile on these offerings and link it to the success of mobile in other industries.

The success stories in the consumer health market that come to my mind are below. Leave a comment or shoot me an e-mail with any suggestions.

WebMD

Walgreens Mobile

MyHumana

Epic MyChart

RunKeeper

Zeo

iTriage

text4baby

ZocDoc

WellDoc

Stay tuned for more analysis and again, please drop me a line if you’ve got any suggestions on companies or products to profile.

Although similar to RunKeeper, and the fact that it’s target market is certainly much different from the metabolic syndrome population you describe, I think Nike+ is worth mentioning and investigating. I’m sure there are lessons to be learned from it’s success that could be applicable to healthcare; particularly in influencing behaviors and the ability to inspire, motivate and encourage ongoing exercise.